Is anterior mediastinum route a shorter choice for esophageal reconstruction? A comparative anatomic study

Abstract

Compared with the posterior route, the anterior route may be considered as a shorter choice for the conduit to reach the cervical region for esophageal reconstruction.

Predictive factors for major postoperative complications related to gastric conduit reconstruction in thoracoscopic esophagectomy for esophageal cancer: a case control study

“…The retrosternal route in almost all cases was applied to the gastric conduit of reconstruction after esophagectomy. There are several advantages of this method for the management of local recurrence, including fewer complications in gastric conduit and a short route in the retrosternal route of reconstruction [ 13 , 35 , 36 ]. In RCT studies, both posterior and anterior mediastinal routes of reconstruction were associated with similar surgical outcomes after esophagectomy for cancer [ 37 ].…”

The effect of narrowed gastric conduits on anastomotic leakage following minimally invasive oesophagectomy

“…Besides the evidence from gastric analysis, several factors have been reported to be associated with anastomotic leakage following oesophagectomy [16], and these factors could contribute to the potential bias of the study. To minimize bias, the inclusion criteria were restricted to: (i) the surgeries were performed by the same experienced surgeon, who had performed over 300 MIOs before the beginning of the study; (ii) only circular stapler anastomotic techniques were applied so that the leakage incidence would not interfere with other anastomotic methods; and (iii) only patients were included in whom the oesophageal bed was used as the route for the conduit pull-up, because the retrosternal route has been reported to be longer than the posterior route [17]. However, the sequential application of two gastric conduits would have built-in bias of learning curve effects in this retrospective study.…”

Laparoscopic management of incarcerated diaphragmatic hernia 6 months post mini-invasive esophagectomy and retrosternal gastroplasty

“…Однако, по данным литературы, доля несосто-ятельности анастомозов при ретростернальном пути проведения составляет от 7,1 до 32,5%. Тем не менее описаны несколько приемов, таких как фиксация зоны анастомоза окружающими тканями, отсечение грудинной части грудино-щитовидной мышцы, мо-делирование широкой трубки (4-6 см), призванных снизить долю несостоятельности анастомозов до 3% [7,8].…”